OncoTargets and Therapy (May 2020)
Pulmonary Lymphoepithelioma-Like Carcinoma: A Mini-Review
Abstract
Yan Hu,1 Siying Ren,2 Yukang Liu,1 Wei Han,1 Wenliang Liu1 1Department of Thoracic Surgery, Second Xiangya Hospital of Central South University, Changsha 410011, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital of Central South University, Changsha 410011, People’s Republic of ChinaCorrespondence: Wenliang LiuDepartment of Thoracic Surgery, Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Road, Changsha, People’s Republic of ChinaTel +8673185296122Email [email protected]: Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare and distinct subtype of non-small-cell lung carcinoma associated with Epstein–Barr virus (EBV) infection. We systematically reviewed the recent research that expands our knowledge about PLELC, with main focus on its genetic profile, tumor-infiltrating environment, PD-L1 expression, circulating EBV-DNA, clinical utility of 18F-FDG PET/CT, and treatment strategy. A low frequency of typical driver mutations and widespread existence of copy number variations was detected in PLELC. Persistent EBV infection may trigger intense infiltration of lymphocytes, representing enhanced tumor immunity and possibly resulting in a better prognosis. Circulating EBV-DNA in the plasma of patients with PLELC may predict disease progression and response to therapy. PLELC is 18F-FDG avid, and 18F-FDG PET may help refine palliation strategies and subsequently improve the prognosis. Most of the reported patients present at early and resectable stage, and surgical resection with curative intent is the preferred approach. There is currently no consensus on the regimen of chemotherapy for patients with advanced stages. EGFR-targeted therapies seem to have no therapeutic effect, and the clinical impact of PD-1/PD-L1 therapy is uncertain but worthy of further research.Keywords: pulmonary lymphoepithelioma-like carcinoma, genetic profile, EBV infection, PD-L1 expression, tumor inflammatory microenvironment, treatment strategy
